摘要
目的探讨体外受精-胚胎移植(IVF-ET)相关急腹症的发生情况、危险因素、临床特点及合理的应对措施。方法回顾分析678个IVF-ET周期急腹症的发生率及其病因,评价获卵数、输卵管病变与急腹症发生的关系,比较生殖专科医生及非生殖专科医生的误诊率。结果 IVF-ET后急腹症发生率为 4．3％,主要病因有:卵巢过度刺激综合征、异位妊娠、卵巢扭转、宫内外同时妊娠。获卵>15个组急腹症发生率显著高于获卵≤15个组(P<0．01)。所有异位妊娠和宫内外同时妊娠急腹症均有输卵管性不孕因素。生殖专科医生误诊率显著低于非生殖专科医生(P<0．05)。结论促排卵药诱发过多卵泡发育、输卵管病变是IVF-ET急腹症发生的危险因素。需要对非生殖专科医生进行IVF-ET知识的普及,对患者进行并发症的宣教以减少误诊率。
Objective To study the occurrence, etiology and risk factors of acute abdomen due to IVF-ET and treatment. Methods Six hundred and seventy-eight IVF-ET cycles from 1998 to 2005 were retrospectively reviewed. The incidence rate of acute abdomen and the causes were analyzed. The relation between the incidence rate and the number of eggs retrieved was analyzed as well as patient＇s history of tubal damage history. The misdiagnositic rate between reproductive-specialty and non-reproductive-specialty doctors was compared. Results The incidence rate of acute abdomen was 4.3%. The main causes were： ovarian hyperstimulation syndrome, ectopic pregnancy, ovarian torsion, and heterotopic pregnancy. The incidence rate of acute abdomen was significantly higher in the 〉 15 oocytes group than in the 15 oocytes group. All patients with the acute abdmen caused by ectopic and heterotopic pregnancy had tubal factor causing infertility. The misdiagnostic rate was signiticanfly lower of reproductive-specialty doctors than non-reproductivespecialty doctors. Condusion Excessive oocytes induced by ovarian hyperstimulation and tubal damage were main risk factors of acute abdomen. To reduce the misdiagnosis, non-reproductive-specialty doctors should know about IVF-ET and patients should be informed about the occurrence of these procedure related complications.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第5期444-447,共4页
Chinese Journal of Emergency Medicine
基金
浙江省卫生厅科研资助项目(2002A056)
关键词
体外受精-胚胎移植
并发症
急腹症
卵巢过度刺激综合征
异位妊娠
卵巢扭转
宫内外同时妊娠
In vitro fertilization-embryo transfer
Complication
Acute abdomen
Ovarian hyperstimulation syndrome
Ectopic pregnancy
Ovarian torsion
Heterotopic pregnancy
